HHS Public Access Author manuscript Author Manuscript
J Hum Hypertens. Author manuscript; available in PMC 2017 September 19. Published in final edited form as: J Hum Hypertens. 2017 November ; 31(11): 731–736. doi:10.1038/jhh.2017.17.
Hypertensive Disorders of Pregnancy in Women with Gestational Diabetes Mellitus on Overweight Status of Their Children Shuang Zhang1, Leishen Wang1, Junhong Leng1, Huikun Liu1, Weiqin Li1, Tao Zhang1,2, Nan Li1, Wei Li1, Huiguang Tian1, Andrea A. Baccarelli3, Lifang Hou4, and Gang Hu2 1Tianjin
Women’s and Children’s Health Center, 96 Guizhou Road, Heping Districts, Tianjin,
China
Author Manuscript
2Chronic
Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA 3Department
of Environmental Health Sciences | Columbia University Mailman School of Public Health, New York, NY, USA 4Department
of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Abstract
Author Manuscript
Hypertensive disorders of pregnancy (HDP) as a group of medical complications in pregnancy are believed to be associated with an increased risk of poor fetal growth, but the influence on offspring’s body composition is not clear. The aim of the present study was to evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of mothers with gestational diabetes mellitus (GDM). A cross-sectional study among 1263 GDM mother-child pairs was performed in Tianjin, China. General linear models and logistic regression models were used to assess the associations of maternal hypertension in pregnancy with anthropometry and overweight status in the offspring from birth to 1–5 years old.
Author Manuscript
Offspring of GDM mothers who were diagnosed with hypertensive disorders during pregnancy had higher mean values of Z scores for birth weight for gestational age and birth weight for length, and higher mean values of Z scores for weight for age, weight for length/height, and body mass index for age at 1–5 years old than those of GDM mothers with normal blood pressure during pregnancy. Maternal hypertensive disorders of pregnancy were associated with increased risks of large for gestational age (OR 1.74, 95%CI 1.08–2.79) and macrosomia (OR 2.02, 95%CI 1.23– 3.31) at birth and childhood overweight/obesity at 1–5 years old age (OR 1.88, 95%CI 1.16–3.04).
Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms Address for correspondence: Gang Hu, PhD, Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA Tel: 225-763-3053, Fax: 225-763-3009, [email protected]. Conflict(s) of Interest/Disclosure Statement None
Zhang et al.
Page 2
Author Manuscript
For offspring of mothers with GDM, maternal hypertension during pregnancy was a risk factor for macrosomia at birth and childhood overweight and obesity, and controlling the maternal hypertension may be more important for preventing large for gestational age babies and childhood obesity.
Introduction
Author Manuscript
Hypertensive disorders of pregnancy as a group of medical complications in pregnancy remain to be a major cause of maternal and infant morbidity and mortality worldwide.1 Several studies have indicated that offspring of women with hypertensive disorders of pregnancy are at increased risk for cardiovascular disease at early adults.2, 3 Other studies have found that maternal hypertensive disorders of pregnancy predict large offspring size at birth and increase the risk of cardio metabolic diseases in the offspring during childhood and adolescence.3, 4 A retrospective cohort study of 16,936 births found that maternal preeclampsia increased the risk of intrauterine growth restriction and low birth weight,5 which in turn is reported to predispose to central obesity, hypertension, coronary heart disease and insulin resistance.6, 7 Another 20-year prospective follow-up birth cohort study found that young adult offspring of maternal hypertensive pregnancies were more likely to be obese or overweight.3 However, most of the studies were focused on the association of hypertensive disorders of pregnancy with fetal growth or offspring cardiovascular disease status in young adults, few studies have assessed the relationship between hypertensive disorders of pregnancy and childhood overweight status at early young years, especially less than 5 years old.
Author Manuscript
Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, 8 is one of the most common complications in pregnancy affecting 2–10% of the pregnancies in the US.9 In urban china, the prevalence of GDM has increased from 2.3% in 1999 to 8.1% in 2010.10, 11 Some studies have found that offspring of mothers exposed to GDM are at increased risk of neonatal adiposity and childhood obesity,12 and women with GDM are associated with an increased risk of hypertensive disorders of pregnancy.13 Our objective was to evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of GDM mothers.
Methods Tianjin GDM screening project
Author Manuscript
Tianjin is the fourth largest city of China with over 13 million residents in 16 country-level administrative areas.14 About 4.3 million people live in six central urban districts. Since 1999, all pregnant women who live in six urban districts have participated in the universal screening for GDM. The average proportion of screened pregnancies was over 91% during 1999–2008.11 Following the WHO’s GDM diagnosis criteria, all pregnant women at 26–30 gestational weeks participated in a 1-hour oral glucose tolerance test (OGTT) with 50-g glucose load. 15 Women who had a glucose reading ≥7.8 mmol/l were invited to undergo a 2-hour OGTT with a 75-g glucose load at the Tianjin Women’s and Children’s Health Center. 15 All women confirming either diabetes (fasting glucose ≥7 mmol/l or 2-hour
J Hum Hypertens. Author manuscript; available in PMC 2017 September 19.
Zhang et al.
Page 3
Author Manuscript
glucose ≥11.1mmol/l) or impaired glucose tolerance (IGT) (2-hour glucose ≥7.8 and 90th percentile, whereas a small-for-gestational-age infant was defined as an infant having a standardized birth weight
J Hum Hypertens. Author manuscript; available in PMC 2017 September 19. Published in final edited form as: J Hum Hypertens. 2017 November ; 31(11): 731–736. doi:10.1038/jhh.2017.17.
Hypertensive Disorders of Pregnancy in Women with Gestational Diabetes Mellitus on Overweight Status of Their Children Shuang Zhang1, Leishen Wang1, Junhong Leng1, Huikun Liu1, Weiqin Li1, Tao Zhang1,2, Nan Li1, Wei Li1, Huiguang Tian1, Andrea A. Baccarelli3, Lifang Hou4, and Gang Hu2 1Tianjin
Women’s and Children’s Health Center, 96 Guizhou Road, Heping Districts, Tianjin,
China
Author Manuscript
2Chronic
Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA 3Department
of Environmental Health Sciences | Columbia University Mailman School of Public Health, New York, NY, USA 4Department
of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Abstract
Author Manuscript
Hypertensive disorders of pregnancy (HDP) as a group of medical complications in pregnancy are believed to be associated with an increased risk of poor fetal growth, but the influence on offspring’s body composition is not clear. The aim of the present study was to evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of mothers with gestational diabetes mellitus (GDM). A cross-sectional study among 1263 GDM mother-child pairs was performed in Tianjin, China. General linear models and logistic regression models were used to assess the associations of maternal hypertension in pregnancy with anthropometry and overweight status in the offspring from birth to 1–5 years old.
Author Manuscript
Offspring of GDM mothers who were diagnosed with hypertensive disorders during pregnancy had higher mean values of Z scores for birth weight for gestational age and birth weight for length, and higher mean values of Z scores for weight for age, weight for length/height, and body mass index for age at 1–5 years old than those of GDM mothers with normal blood pressure during pregnancy. Maternal hypertensive disorders of pregnancy were associated with increased risks of large for gestational age (OR 1.74, 95%CI 1.08–2.79) and macrosomia (OR 2.02, 95%CI 1.23– 3.31) at birth and childhood overweight/obesity at 1–5 years old age (OR 1.88, 95%CI 1.16–3.04).
Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms Address for correspondence: Gang Hu, PhD, Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA Tel: 225-763-3053, Fax: 225-763-3009, [email protected]. Conflict(s) of Interest/Disclosure Statement None
Zhang et al.
Page 2
Author Manuscript
For offspring of mothers with GDM, maternal hypertension during pregnancy was a risk factor for macrosomia at birth and childhood overweight and obesity, and controlling the maternal hypertension may be more important for preventing large for gestational age babies and childhood obesity.
Introduction
Author Manuscript
Hypertensive disorders of pregnancy as a group of medical complications in pregnancy remain to be a major cause of maternal and infant morbidity and mortality worldwide.1 Several studies have indicated that offspring of women with hypertensive disorders of pregnancy are at increased risk for cardiovascular disease at early adults.2, 3 Other studies have found that maternal hypertensive disorders of pregnancy predict large offspring size at birth and increase the risk of cardio metabolic diseases in the offspring during childhood and adolescence.3, 4 A retrospective cohort study of 16,936 births found that maternal preeclampsia increased the risk of intrauterine growth restriction and low birth weight,5 which in turn is reported to predispose to central obesity, hypertension, coronary heart disease and insulin resistance.6, 7 Another 20-year prospective follow-up birth cohort study found that young adult offspring of maternal hypertensive pregnancies were more likely to be obese or overweight.3 However, most of the studies were focused on the association of hypertensive disorders of pregnancy with fetal growth or offspring cardiovascular disease status in young adults, few studies have assessed the relationship between hypertensive disorders of pregnancy and childhood overweight status at early young years, especially less than 5 years old.
Author Manuscript
Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, 8 is one of the most common complications in pregnancy affecting 2–10% of the pregnancies in the US.9 In urban china, the prevalence of GDM has increased from 2.3% in 1999 to 8.1% in 2010.10, 11 Some studies have found that offspring of mothers exposed to GDM are at increased risk of neonatal adiposity and childhood obesity,12 and women with GDM are associated with an increased risk of hypertensive disorders of pregnancy.13 Our objective was to evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of GDM mothers.
Methods Tianjin GDM screening project
Author Manuscript
Tianjin is the fourth largest city of China with over 13 million residents in 16 country-level administrative areas.14 About 4.3 million people live in six central urban districts. Since 1999, all pregnant women who live in six urban districts have participated in the universal screening for GDM. The average proportion of screened pregnancies was over 91% during 1999–2008.11 Following the WHO’s GDM diagnosis criteria, all pregnant women at 26–30 gestational weeks participated in a 1-hour oral glucose tolerance test (OGTT) with 50-g glucose load. 15 Women who had a glucose reading ≥7.8 mmol/l were invited to undergo a 2-hour OGTT with a 75-g glucose load at the Tianjin Women’s and Children’s Health Center. 15 All women confirming either diabetes (fasting glucose ≥7 mmol/l or 2-hour
J Hum Hypertens. Author manuscript; available in PMC 2017 September 19.
Zhang et al.
Page 3
Author Manuscript
glucose ≥11.1mmol/l) or impaired glucose tolerance (IGT) (2-hour glucose ≥7.8 and 90th percentile, whereas a small-for-gestational-age infant was defined as an infant having a standardized birth weight
